Provider and Parks Partnership Shows Improvement in Pediatric Obesity Measures
The study showed improvements in weight and overall health markers.
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DURHAM, N.C. – Referrals by pediatric primary care providers to a community-led lifestyle program helped improve the health of pediatric patients with obesity, according to research led by Duke Health.
The study, published Feb. 10 in Pediatrics, looked at 255 children with obesity between the ages of 5-17 and found those who were randomly selected to participate in a six-month program called Fit Together saw significant improvements in body mass index and markers of overall health. The program, organized by Durham Parks and Recreation, provided six hours of classes per week to participants and their families, focused on physical activity and nutrition.
Researchers said the program solves a healthcare delivery problem by giving clinicians a way to prescribe a lifestyle intervention in a manner that is accessible to patient families.
“Clinicians have a brief amount of time to make an impact during an annual visit and simply telling people to eat healthier or providing superficial counseling doesn't work,” said Sarah Armstrong, M.D., corresponding author of the study and professor in the Department of Pediatrics at the Duke University School of Medicine.
“Intensive lifestyle treatment programs can make an impact, but they are hard to find and often expensive or not acceptable for families. Having a municipal program offer these services to children and their families allows clinicians to make a recommendation that is accessible, actionable, and meaningful,” Armstrong said.
All program participants saw improvements in BMI and overall health compared with the control group. However, there were no significant changes between the groups on cardiovascular fitness. The study faced limitations due to the COVID-19 pandemic. Children who participated in the program and did not experience COVID-related interruptions saw the highest improvement.
“Municipal partners provide valuable resources to the communities they serve. By partnering clinics and communities, each can provide their knowledge and resources to improve the health of residents,” said fellow study author Cody Neshteruk, Ph.D., assistant professor in the Departments of Population Health Science and Pediatrics at the Duke University School of Medicine.
In addition to accessibility, researchers said another noteworthy aspect of the program is the opportunity for participants to receive intensive lifestyle support in a setting where everyone in the group has the same diagnosis, all of which may make engagement easier.
Armstrong said that while programs like Fit Together can be an impactful treatment tool, lifestyle treatment should be considered in combination with existing therapies for weight loss, such as GLP1 medication.
The study team is working with various municipalities to launch similar programs across the country. They also partnered with Durham Parks and Recreation to launch an online version of the program.
In addition to Armstrong and Neshteruk, study authors include Jennifer S. Li, William E. Kraus, Svati Shah, Mary Story, Nancy Zucker, Jason Jones, Eliana M. Perrin, Alexandra R. Zizzi, Joshua Burrows, Brooke E. Wagner, McAllister Windom, Tracy Truong, Hwanhee Hong, and Asheley C. Skinner.
This study was funded by the American Heart Association (17SFRN33670990, 17SFRN33671003, 17SFRN33700117, and 17SFRN33700155), the National Institutes of Health (R24-DK110492 and 5R01-HL127009), and the Duke Endowment.